Abstract Twenty percent of the U.S. population resides in rural communities. In rural areas, residents need to travel greater distances to access specialty services of the healthcare system. Typically, healthcare facilities in these rural areas are small and provide limited services. Often, due to geographic distance, extreme weather conditions, environmental and climatic barriers, lack of public transportation, and challenging roads, rural residents may be limited or prohibited from accessing specialty health care services. In this phase II proposal, Koronis Biomedical Technologies (KBT) proposes a system to overcome some of these barriers by monitoring cystic fibrosis (CF) patients at home. Currently, the standard of care for reoccurring CF respiratory exacerbations includes coming to a specialized CF clinic or the hospital for pulmonary function evaluation when symptoms occur. Pulmonary function tests help clinicians know when lung function has declined. However, clinicians currently do not monitor lung function at home, nor do clinicians have any insight on therapy adherence. There are currently 120 CF centers in the U.S. accredited by the Cystic Fibrosis Foundation with only five in the entire states of Minnesota (2), North/South Dakota (2), Montana (1) and Wyoming (0). In many cases, patients travel a long distance to reach these specialized CF centers. The proposed system creates an innovative home system that connects patients in rural areas with clinicians and provides a feedback loop between therapy and diagnostic monitoring. The phase II proposal will develop a web application that will allow secure remote access to pulmonary function data and therapy adherence. This system will provide a means of early detection of pulmonary exacerbation and reducing the number of costly and stressful hospitalizations and clinic visits.